In the 1994 film Reality Bites, there's a monologue that could easily represent an entire generation's terrified thinking on the topic of HIV. As Vickie (Janeane Garofalo) waits on her test results, she relays her anxiety to friend Lelaina (Winona Ryder). "Every day, all day, it's all that I think about, okay?" she says. "Every time I sneeze, it's like I'm four sneezes away from the hospice, and it's like it's not even happening to me. It's like I'm watching it on some crappy show like Melrose Place. And I'm the new character, I'm the HIV-AIDS character, and I live in the building and I teach everybody that it's okay to be near me, it's okay to talk to me, and then I die. And there's everybody at my funeral wearing halter tops and chokers."
Many of us who came of age in the nineties grew up irrationally terrified of contracting the disease. We were victims of scare-tactic sexual education, spoon-fed high-drama media depictions of both the risk and the ramifications of the virus. It was a feeling we were unable to shake, even as medical advancements meant that HIV became something you can prevent, treat and live with.
Vickie is right to mention prime-time drama as a defining point in our collective (and sustained) anxiety. The same year Reality Bites was released, Melrose Place really did feature a short-lived, lesson-teaching HIV-positive character, while NBC's ER devoted eight full episodes of its first season to addressing AIDS. A few years later, 90210's Kelly Taylor volunteered at an AIDS hospice and the show introduced a patient who eventually dies, three episodes later, with Kelly at his bedside.
Television was once rife with didactic prop characters used to teach viewers that anyone can contract the virus. When Degrassi High introduced AIDS into its narrative in 1990 – way ahead of its American counterparts – HIV-positive Dwayne Myers primarily functioned as a way to let young people that HIV wasn't a "gay disease" and that schoolmates couldn't become infected by sharing a seat in a classroom. "You can talk to them, you can shake their hand, hug them, that's all safe."
Twenty years after Vickie lamented Melrose Place, though, the treatment of HIV-positive characters on television has shifted with both attitudes and medical advancements. Witness How To Get Away With Murder and its recently diagnosed character Oliver Hampton (Conrad Ricamora). In some ways, his storyline plays out with that familiar 1990s after-school special tone. Oliver is the "good boy" half of his coupling with the promiscuous Connor Walsh (Jack Falahee). His diagnosis was written as an unexpected and shocking revelation, allowing the show to deliver that standard, decades-old messaging that anyone is at risk.
But as his story picks up in the second season, things become more progressive. The pair stay together, with Connor enthusiastic to have sex, and moving in to show his commitment to working through and with the diagnosis. It's a warm and honest portrait of a couple navigating the workable realities of HIV, one that doesn't suggest the news is dire, but instead needs to be incorporated into their lives. In a show known for its extreme twists and occasionally unbelievable plot lines, their relationship is grounded in a very human reality. Beyond that, Oliver's status is a detail – not the sole dramatic reason for his existence on the show – a remarkable change in the mainstream when it comes to depicting those living with HIV.
I asked Mason McColl, the gay men's online strategy and resource co-ordinator for the AIDS Committee of Toronto (ACT), to watch the show and share his thoughts on this new, very different approach. "The way the show navigated Connor's fear of getting tested and the couple's negotiation of testing, condomless sex and monogamy, those are stories that we see play out in real life, and we have seen depicted in gay media before, but never so boldly in a mainstream show," he told me.
The show also does a good job of modelling appropriate behaviour for allies. Far from the Degrassi open classroom chats, HTGAWM sends a clear message about privacy issues, with Connor, for instance, chastised for disclosing Oliver's HIV status to his colleagues. (Asher, the bumbling privileged dude component of the show's casting, is also mocked for his attempt at empathy through a laughable "Philadelphia's one of my favourite movies" line.)
But what's most notable is when Oliver expresses his reluctance to have sex if he's putting his partner in danger, Connor responds that he's on PrEP. The show gives very little exposition in terms of what PrEP actually is, or how the drug is changing the landscape of HIV prevention. PrEP (pre-exposure prophylaxis) is an option for those who are at high risk of contracting HIV (such as those who, like Connor, are in relationships with people who are infected). The drug is used consistently, as a pill taken daily, and often combined with other safer sex methods such as condoms. It's currently not approved in Canada, but is prescribed "off label," meaning doctors offer the drug (Truvada) for reasons other than what it is officially available for.
Without approval from Health Canada, many doctors are unwilling to prescribe PrEP off label, and using PrEP may not be able to get insurance to cover the high cost of the drug. Yet HTGAWM is talking about the drug in a high-profile space, encouraging viewers to ask questions and arm themselves with information.
"If nothing else, [HTGAWM] will introduce a new concept to the general public, who for the most part, especially in Canada, don't know about PrEP," McColl says.
All this, of course, doesn't mean the work is done when it comes to HIV on TV.
Despite being a commendable addition to the landscape, Oliver is still constructed as the quintessential relatable nice guy, meaning viewers are apt forgive him for the circumstances that led to his diagnosis. As McColl rightly points out, if Connor had been the one to receive a positive test result, we'd be having a very different conversation – one about the blame and stigma that continues to be heaped upon those who engage in casual sex.
Cautious caveats aside, HTGAWM's storyline is admirable advocacy via realistic portrayal, lacking the fear and heavy-handed moral dictums of decades past. Perhaps this signals the start of a new and better informed conversation – one that's less about being terrified while waiting on test results, and more about feeling empowered when they arrive.